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Canada needs a national seniors’ strategy

All levels of government are at risk of being overwhelmed by Canada’s growing senior population and the health system’s inability to meet their needs.

A national plan to deal with health care for seniors should be high on the agenda for Canada's premiers when they meet in Ottawa on Jan. 30, 2015. In this photo, Ontario Premier Kathleen Wynne, P.E.I. Premier Robert Ghiz and Quebec Premier Philippe Couillard wrap up the last meeting on Aug. 29, 2014. (Andrew Vaughan / THE CANADIAN PRESS)

By Christopher SimpsonMorel CaissieKarima Velji

Thu., Jan. 29, 2015

As Canada’s premiers prepare to gather in Ottawa on Jan. 30 to meet as the Council of the Federation, we would like to remind them why a national seniors’ strategy must be high on their agenda.

Among those aged 15 and over who provide care to an immediate family member with a chronic condition, 16.5 per cent reported very high levels of stress. Some 35 per cent of the workforce is providing care to a relative or friend, accounting for an annual loss in productivity of $1.3 billion.

Statistics Canada reports that family caregivers contribute an estimated $5 billion of unpaid labour to the health-care system. As our country’s older population grows, the need for care will only multiply. Recent Nanos public opinion polls conducted for the Canadian Medical Association and the Canadian Nurses Association found that an overwhelming majority of Canadians want the federal parties to improve financial support to family caregivers and to make seniors’ care part of their election platforms.

The tumbling dollar and sagging oil prices may get the headlines from the Jan. 30 council meeting. The real story, however, is how our municipal, provincial and federal treasuries are at risk of being overwhelmed by Canada’s growing senior population and the health-care system’s inability to meet the demand.

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The federal government has made a start with the creation of the Employer Panel for Caregivers and the Family Caregiver Tax Credit. However, it must do more to make a meaningful difference in the lives of Canadians caring for family members. For example, making the caregiver tax credit refundable would help mitigate care costs such as paying out of pocket for prescriptions, groceries and personal care items or taking time off work for medical appointments.

Until all levels of government come together to form a comprehensive pan-Canadian seniors’ strategy, piecemeal initiatives will have a limited impact.

In a way, our generation has become a victim of our own success. Progress and innovation in medicine mean Canadians are living longer.

At the same time, more people are living with chronic diseases that complicate both their health status and the treatment they need. Treatment of chronic diseases consumes 67 per cent of all direct health-care costs.

Chronic disease is the main reason seniors require health care. In 2011, between 74 and 90 per cent of Canada’s seniors suffered from at least one chronic condition, while nearly one-quarter had two or more. These conditions jeopardize a person’s ability to live independently at home. On any given day in Canada, “alternative level of care” patients — that is, patients approved for hospital discharge who cannot access appropriate post-hospital care — occupy about 7,500 beds. Hospitals are routinely forced into a state of overcapacity called “code gridlock” in which patient flow grinds to a halt, elective surgeries are cancelled and transfers are put on hold.

If you are in a car accident or have a heart attack, our health-care system can effectively mobilize world-class acute health-care services. But the system is woefully inadequate and under-resourced to properly prevent, manage or treat the long-term and chronic health problems facing most of our over 65 population.

Too often, seniors who could and should be getting better are languishing in hospitals when more efficient and effective care could be delivered in their homes or in a long-term care facility. It costs $1,000 to keep a person in a hospital bed for a day. Long-term care costs $130 a day. Home care (excluding the economic costs of caregivers looking after relatives) costs $55. That translates to approximately $2.3 billion a year that could be better spent in the health-care system with some strategic thinking and investing.

This country as we know it today was, in fact, built by our seniors — by our own mothers and fathers, aunts and uncles and grandparents. Canada’s health-care providers are determined and committed to prioritizing and improving their health. We expect the same of our country’s leaders. As the premiers gather just blocks from Parliament Hill, we ask that a comprehensive healthy aging and seniors’ care strategy be at the top of their agenda.

Christopher Simpson, MD, is president of the Canadian Medical Association. Morel Caissie is president of the Canadian Association of Social Workers. Karima Velji is president of the Canadian Nurses Association.

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